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5. Risk for Major Bleeding in Patients Receiving Ticagrelor Compared With Aspirin After Transient Ischemic Attack or Acute Ischemic Stroke in the SOCRATES Study (Acute Stroke or Transient Ischemic Attack Treated With Aspirin or Ticagrelor and Patient Outcomes)

Author

Easton, J. Donald, Aunes, Maria, Albers, Gregory W., Amarenco, Pierre, Bokelund-Singh, Sara, Denison, Hans, Evans, Scott R., Held, Peter, Jahreskog, Marianne, Jonasson, Jenny, Minematsu, Kazuo, Molina, Carlos A., Wang, Yongjun, Wong, K.S. Lawrence, Johnston, S. Claiborne, Ameriso, Sebastiá F., Donnan, Geoffrey, Lemmens, Robin, Massaro, Ayrton, Titianova, Ekaterina, Hill, Michael D., Lavados, Pablo, Skoloudik, David, Röther, Joachim, Norbert, Szegedi, Agnelli, Giancarlo, Bornstein, Natan, Tanahashi, Norio, Góngora, Angel Arauz, Pretell, Edwin, San Jose, Maria Cristina Z., Czlonkowska, Anna, Bajenaru, Ovidiu, Stakhovskaya, Ludmila, Brozman, Miroslav, Kim, Jong-Sung, Wahlgren, Nils, Michel, Patrik, Lee, Tsong Hai, Suwanwela, Nijasri Charnnarong, Kutluk, Kursad, Moskovko, Sergii, Kasner, Scott, Laskowitz, Daniel, Clark, Wayne, Nguyen, Huy Thang, Ameriso, Sebastian, Lepera, Sandra, Romano, Marina, Paulon, David, Ioli, Pablo, Zurru, Cristina, Bruera, Guadalupe, Jure, Lorena, Klein, Francisco, Povedano, Guillermo, Levi, Christopher, Phan, Thanh, Markus, Romesh, Anderson, Craig, Sabet, Arman, Davis, Stephen, Lee, Andrew, Kleinig, Timothy, Wong, Andrew, Krause, Martin, Jannes, Jim, Wijeratne, Tissa, Lemmens, Robin, Hemelsoet, Dimitri, Peeters, André, Tack, Philippe, Vanacker, Peter, Laloux, Patrice, Van Landegem, William, Vanhooren, Geert, Desfontaines, Philippe, Van Orshoven, Marc, Oliveira, Fabio, Friedrich, Mauricio, Brondani, Rosane, Gagliardi, Rubens, Fabio, Soraia, Dracoulakis, Marianna, Bazan, Rodrigo, Marrone, Luiz, Pontes Neto, Octavio, Silva, Gisele, Kowacs, Pedro, Titianova, Ekaterina, Stamenova, Paraskeva, Daskalov, Marin, Staikov, Ivan, Baldaranov, Dimo, Maslarov, Dimitar, Lilovski, Hristo, Petkov, Plamen, Petrova, Neli, Mavrov, Radoslav, Markova, Veska, Petrova, Valeria, Beleva, Tanya, Kralev, Borislav, Sotirov, Nikolay, Lekova, Veska, Hristov, Dimcho, Ermenkova, Vera, Mateev, Lyudmil, Mitkova, Rumeliya, Haralanov, Liybomir, Ikonomov, Rosen, Mihailova, Margarita, Georgiev, Ivan, Shuaib, Ashfaq, Hachinski, Vladimir, Boulanger, Jean-Martin, Mann, Sharan, Hassan, Ayman, Mackey, Ariane, Menon, Bijoy, Minuk, Jeffrey, Siddiqui, Muzaffar, Eustace, Marsha, Vieira, Lucia, Selchen, Daniel, Beaudry, Michel, Stotts, Grant, Lavados, Pablo, Castro, Angel, Gasic, Kristo, Rivas, Rodrigo, Sanchez, Pablo, Roldan, Andres, Grossmann, Ingrid, Figueroa, Christian, Li, Jimei, Xu, Xiaolin, Chen, Huisheng, Li, Xiaohong, Yang, Yi, Zhang, Chunsheng, Wang, Baojun, Li, Guanglai, Wang, Dong, Lin, Hong, Tang, Yamei, Xu, Anding, Wang, Yanjiang, Hong, Wenke, Song, Zhi, Zhang, Xu, Jin, Xiaoping, Xu, Yun, Yan, Fuling, Zheng, Weihong, Wang, Xiaoping, Dong, Qiang, Zhao, Zhongxin, Zhang, Baorong, Zhong, Wangtao, Wen, Guoqiang, Xu, Jun, Li, Guozhong, Dong, Xueshuang, Tian, Xiangyang, Zhang, Zhaohui, Xu, En, Liu, Kaixiang, Chen, Jun, Skoda, Ondrej, Skoloudik, David, Ehler, Edvard, Vaclavik, Daniel, Sanak, Daniel, Klimosova, Sylva, Vitkova, Eva, Fiksa, Jan, Mikulik, Robert, Neumann, Jiri, Plny, Richard, Leys, Didier, Sibon, Igor, Mas, Jean-Louis, Alamowitch, Sonia, Pico, Fernando, Hosseini, Hassan, Mahagne, Marie-Hélène, Touze, Emmanuel, Vadot, Wilfried, Vannier, Stéphane, Nighoghossian, Norbert, Samson, Yves, Garnier, Pierre, Ellie, Emmanuel, Guillon, Benoît, Timsit, Serge, Giroud, Maurice, Philippeau, Frédéric, Bagan-Triquenot, Aude, Wolff, Valérie, Raposo, Nicolas, Obadia, Michel, Debiais, Severine, Grimaud, Jérôme, Illouz, Stéphane, Smadja, Didier, Urbanczyk, Cédric, Röther, Joachim, Berrouschot, Jörg, Weimar, Christian, Gahn, Georg, Soda, Hassan, Klimpe, Sven, Nabavi, Darius, Glahn, Jörg, Köhrmann, Martin, Krause, Lars, Terborg, Christoph, Urban, Peter, Steiner, Thorsten, Ferbert, Andreas, Dziewas, Rainer, Seidel, Günter, Thomalla, Götz, Li, Richard, Fong, Wing Chi, Cheung, Raymond, Szegedi, Norbert, Pozsegovits, Krisztián, Valikovics, Attila, Pánczél, Gyula, Rózsa, Csilla, Németh, László, Diószeghy, Péter, Óváry, Csaba, Csányi, Attila, Kerényi, Levente, Nagy, Valéria, Komoly, Sámuel, Bereczki, Dániel, Molnár, Sándor, Kondákor, István, Tanne, David, Raphaeli, Guy, Telman, Gregory, Bornstein, Natan, Leker, Ronen, Lampl, Yair, Agnelli, Giancarlo, Corea, Francesco, Ricci, Stefano, Guidetti, Donata, Malferrari, Giovanni, Marcheselli, Simona, Micieli, Giuseppe, Zini, Andrea, Di Lazzaro, Vincenzo, Gandolfo, Carlo, Salmaggi, Andrea, Tassi, Rossana, Rasura, Maurizia, Orlandi, Giovanni, Comi, Giancarlo, Ricci, Stefano, Mancuso, Michelangelo, Delodovici, Marialuisa, Bovi, Paolo, Consoli, Domenico, Utsugisawa, Kimiaki, Fujita, Tsuneo, Kurihara, Hideyuki, Maruki, Chikashi, Hayashi, Takeshi, Ogiichi, Tsuneaki, Kumagai, Morio, Takenaka, Katsunobu, Toyoda, Kazunori, Takamatsu, Kazuhiro, Ogami, Ryo, Kin, Shigenari, Aoki, Takeshi, Takizawa, Katsumi, Omori, Shigehiro, Umezawa, Takehiko, Toba, Yasuyuki, Nonoyama, Yutaka, Nakagawa, Hidemitsu, Naka, Takashi, Morimoto, Masanori, Matsumoto, Shuichi, Hitotsumatsu, Tsutomu, Shingaki, Tatsuya, Okuda, Satoshi, Ota, Mamoru, Sakai, Nobuyuki, Yamada, Takeshi, Niwa, Jun, Fujita, Hitoshi, Moriki, Akihito, Yoshino, Kimihiro, Fukushima, Yoshihisa, Mori, Takahisa, Sato, Atsushi, Kusano, Yoshikazu, Kubo, Michiya, Yamazaki, Masashi, Ooasa, Takao, Nishizaki, Takafumi, Kitagawa, Naoki, Yasaka, Masahiro, Manabe, Yasuhiro, Yoshioka, Akira, Ishihara, Masayuki, Kagawa, Takato, Ichihashi, Toshikazu, Matsuoka, Hideki, Ito, Yasuhiro, Yamasaki, Masahiro, Takaba, Hitonori, Saito, Hisatoshi, Sato, Masahiro, Fukuda, Kazumasa, Endo, Sumio, Kidooka, Minoru, Umemura, Toshitaka, Kikkawa, Yuriko, Toru, Shuta, Yamada, Kentaro, Sakai, Hideki, Asari, Jun, Ezura, Masayuki, Nitta, Hisashi, Nagano, Keiko, Ochiai, Jun, Sakai, Keiichi, Kobayashi, Yasutaka, Yoshii, Yasuhiro, Miake, Hirotomo, Takita, Tomohiro, Taniguchi, Hidekazu, Kuroki, Kazuhiko, Mizota, Takamitsu, Yamamoto, Kenichi, Nakane, Hiroshi, Iwanaga, Takeshi, Chiba, Kei, Yoshimoto, Tetsuyuki, Torii, Tsuyoshi, Kitagawa, Takeo, Takashima, Hiroshi, Shirasaki, Naoki, Dehara, Makoto, Wada, Naomichi, Hamada, Kensuke, Kato, Noriyuki, Go, Yoshinori, Izumi, Ichiro, Ninomiya, Hirotomo, Kumai, Junichiro, Nakajima, Yoshikazu, Kaku, Yasuhiko, Isayama, Yukihiro, Kawanishi, Masahiro, Noda, Shinya, Yamamoto, Kazuhide, Hazama, Takanori, Takahashi, Hiroshi, Tanaka, Yohei, Hata, Takashi, Kazekawa, Kiyoshi, Furui, Eisuke, Hondo, Hideki, Sato, Nobuyuki, Kusunoki, Katsusuke, Nanri, Kazunori, Abe, Satoshi, Sasaoka, Noboru, Kuroyanagi, Takayuki, Suzuki, Hisahiko, Fukuyama, Kouzou, Nakahara, Kimihiro, Gongora, Fernando, Góngora, Angel Arauz, Cantú Brito, Carlos, Villarreal Careaga, Jorge, Vazquez Alfaro, Rosalia, Aguayo Leytte, Geronimo, Berrospi, Percy, Chavez, Carlos, Pretell, Edwin, Rodriguez, Liliana, Custodio, Nilton, Castañeda, Cesar, Perez, Julio, San Jose, Maria Cristina, Baroque, Alejandro, Collantes, Epifania, Aquino, Abdias, Díaz, Alejandro, Roxas, Artemio, Jr, Lokin, Johnny, Advincula, Joel, Calderon, Emerito, Navarro, Jose, Hiyadan, John, Surdilla, Arturo, Czlonkowska, Anna, Ryglewicz, Danuta, Krychowiak, Grzegorz, Fryze, Waldemar, Sobolewski, Piotr, Nowak, Ryszard, Fiszer, Urszula, Papierowska, Beata, Zielińska-Turek, Justyna, Lasek-Bal, Anetta, Kołodziejska, Ewa, Kamińska, Anna, Adamkiewicz, Bożena, Tutaj, Andrzej, Szkopek, Dorota, Musiatowicz, Krzysztof, Bąk, Zbigniew, Brzozowski, Sławomir, Brola, Waldemar, Ferens, Antoni, Zalisz, Marek, Rejdak, Konrad, Rudzińska, Monika, Bajenaru, Ovidiu, Panea, Cristina, Simu, Mihaela, Balasa, Rodica, Cuciureanu, Iulian, Popescu, Bogdan, Sabau, Monica, Roman-Filip, Corina, Pimenov, Leonid, Gekht, Alla, Milto, Anna, Shchukin, Ivan, Parfenov, Vladimir, Stakhovskaya, Liudmila, Arkhipov, Mikhail, Sokolova, Nadezhda, Bogdanov, Enver, Esin, Radiy, Khasanova, Dina, Golikov, Konstantin, Melnikova, Elena, Zaslavskiy, Leonid, Voznyuk, Igor, Nazarov, Alexander, Akhmadeeva, Leila, Iakupova, Aida, Shamalov, Nikolay, Belskaya, Galina, Chuprina, Svetlana, Denisova, Olga, Drozdova, Ekaterina, Karakulova, Yuliya, Sholomov, Ilya, Spirin, Nikolay, Vostrikova, Elena, Mordvintseva, Elena, Grigoryeva, Vera, Zateyshchikov, Dmitry, Gorbachev, Vladimir, Chefranova, Zhanna, Dudarev, Mikhail, Nilk, Rostislav, Rozhdestvenskiy, Alexey, Gurcik, Ladislav, Dvorak, Miloslav, Krastev, Georgi, Kurca, Egon, Vyletelka, Juraj, Brozman, Miroslav, Kim, Jong Sung, Bae, Hee-Joon, Kim, Yong-Won, Kim, Joon-Tae, Cha, Jae-Kwan, Nam, Hyo Suk, Chang, Dae-Il, Lee, Yong-Seok, Oh, Kyungmi, Yu, Sung-Wook, Sohn, Sung-Il, Lee, Jun, Cho, Han Jin, Kim, Eung-Gyu, Rha, Joung-Ho, Kim, Seo Hyun, Molina Cateriano, Carlos, Serena Leal, Joaquín, Vivancos Mora, José, Rodríguez Yañez, Manuel, Roquer González, Jaume, Purroy García, Francisco, Gomis Cortina, Meritxell, Masjuan Vallejo, Jaime, Arenillas Lara, Juan, Segura Martín, Tomás, Herrero, José Antonio Egido, Tembl Ferrairó, Jose Ignacio, Gállego Culleré, Jaime, Moniche Álvarez, Francisco, Steinberg, Anna, Callander, Margarita, Laska, Ann Charlotte, Bokemark, Lena, Mooe, Thomas, Käll, Tor-Björn, Welin, Lennart, Sjöblom, Lars, Hambraeus, Joakim, Teichert, Jörg, Wannberg, Hans, Sanner, Johan, Ramströmer, Bo, Ziedén, Bo, Hau, Stefan Olsson, Gustafsson, Claes, Michel, Patrik, Kahles, Timo, Lyrer, Philippe, Arnold, Marcel, Liesch, Martin, Medlin, Friedrich, Cereda, Carlo, Kägi, Georg, Luft, Andreas, Carrera, Emmanuel, Lee, Tsong-Hai, Po, Helen L., Chern, Chang-Ming, Lien, Li-Ming, Chan, Lung, Liu, Chung-Hsiang, Wu, Shey-Lin, Lee, Jiann-Der, Chen, Chih-Hung, Lin, Huey-Juan, Lin, Ruey-Tay, Chen, Wei-Hsi, Sun, Yu, Suwanwela, Nijasri Charnnarong, Tantirittisak, Tasanee, Muengtaweepongsa, Sombat, Nilanont, Yongchai, Tiamkao, Somsak, Udommongkol, Chesda, Watcharasaksilp, Kanokwan, Jantararotai, Witoon, Kutluk, Kursad, Sirin, Hadiye, Ince, Birsen, Asil, Talip, Arsava, Murat, Incesu, Tulay Kurt, Tireli, Hulya, Kucukoglu, Hayriye, Ak, Fikri, Unal, Ali, Ozturk, Serefnur, Uzuner, Nevzat, Chmyr, Galyna, Lebedynets, Volodymyr, Nikonov, Vadym, Shulga, Lyudmyla, Smolanka, Volodymyr, Moskovko, Sergii, Khavunka, Marta, Yavorska, Valentyna, Tomakh, Nataliya, Kozyolkin, Olexandr, Litovaltseva, Galyna, Lansberg, Maarten, Bernstein, Richard, Brown, David, Clark, Wayne, Dissin, Jonathan, Graffagnino, Carmelo, Harris, Jonathan, Hicks, William, Kasner, Scott, Katzan, Irene, Kramer, Jeffrey, Willey, Joshua, Silliman, Scott, Starkman, Sidney, Thaler, David, Tremwel, Margaret, Concha, Mauricio, Rajamani, Kumar, Dandapani, Bhuvaneswari, Silver, Brian, Deal, Nathan, Chang, Ira, Hassan, Ameer, Rudolph, Steven, Fischer, Kenneth, Kirshner, Howard, Logan, William, Mallenbaum, Sidney, Hefzy, Hebah, Latorre, Julius, Levine, Steven, Ciabarra, Anthony, Dafer, Rima, Anyanwu, Benjamin, Cherian, Laurel, Panezai, Spozhmy, Khanna, Anna, Dodds, Jodi, Torbey, Michel, Gebel, James, Woo, Henry, Chiu, David, Androulakis, Xiao, Burgin, William, Pineda, Maria, Yilmaz, Engin, Altafullah, Irfan, Boutwell, Christine, Cruz-Flores, Salvador, Sapkota, Biggya, Fayad, Pierre, Jacoby, Michael, Rafiq, Shahid, Salgado, Efrain, Lafranchise, Eugene, Felton, Warren, Madhavan, Ramesh, Zaidat, Osama, Pieper, Connie, Riviello, Ralph, Burnett, Aaron, Fischer, Michelle, Gentile, Nina, Calder, Christopher, Dietrich, Dennis, Cross, Jonathan, Blankenship, Larry, Dafer, Rima, Montoya, Liliana, Grogan, Wendell, Young, Mark, Khan, Farrukh, Campbell, Duane, Daboul, Nizar, Espinoza, Andrey, Cullis, Paul, Concepcion, Gilberto, Wulff, John, Afzal, Haider, Jaffrani, Naseem, Reiter, William, Arshad, Tamjeed, Lukovits, Timothy, Welker, James, Chang, Fen Lei, Badruddin, Aamir, Babikian, Viken, Menon, Ravi, Sander, James, Springer, Mellanie, Nanda, Ashish, Mas, Luis, Rajan, Raj, Silverman, Bruce, Hefzy, Hebah, Huang, David, Carpenter, David, Clark, Joni, Ching, Marilou, Santhakumar, Sunitha, Gould, Jeffrey, Bansal, Vibhav, Vidal, Gabriel, Mikesell, Timothy, Brick, John, French, William, Shah, Qaisar, Holmstedt, Christine, Ishag-Osman, Nadir, Kostis, John, Shehadeh, Abbas, Sethi, Pramodkumak, Imam, Asher, Mccomas, Carl, Tran, Duc, Gebreyohanns, Mehari, Wiseman, Brian, Malik, Maheen, Schwarcz, Aron, Altschul, Dorothea, Castaldo, John, Alshekhlee, Amer, Gancher, Stephen, Krish, Nagesh, Nguyen-Huynh, Mai, Tremwell, Margaret, Sharma, Jitendra, Lee, Lance, Neil, William, Siddiqui, Fazeel, Malek, Ali, Romero, Charles, Huy, Thang Nguyen, Hoang, Hoa, Nguyen, Thang, Nguyen, Anh, and Nguyen, Hung

Published
2017
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7. Improving door-to-reperfusion time in acute ischemic stroke during the COVID-19 pandemic: experience from a public comprehensive stroke center in Brazil.

Author

Klu, Marcelo, Claudia de Souza, Ana, Augusto Carbonera, Leonardo, Leite Secchi, Thais, Pille, Arthur, Rodrigues, Marcio, Brondani, Rosane, Garcia de Almeida, Andrea, Dal Pizzol, Angélica, Freire Camelo, Daniel Monte, Paulo Mantovani, Gabriel, Oldoni, Carolina, Somma Tessari, Marcelo, Antonio Nasi, Luiz, and Ouriques Martins, Sheila Cristina

Subjects
ISCHEMIC stroke, COVID-19 pandemic, STROKE units, STROKE, STROKE patients, BOLUS radiotherapy, COMPUTED tomography
Abstract

Background: The global COVID-19 pandemic has had a devastating e􀀀ect on global health, resulting in a strain on healthcare services worldwide. The faster a patient with acute ischemic stroke (AIS) receives reperfusion treatment, the greater the odds of a good functional outcome. To maintain the time-dependent processes in acute stroke care, strategies to reorganize infrastructure and optimize human and medical resources were needed. Methods: Data from AIS patients who received thrombolytic therapy were prospectively assessed in the emergency department (ED) of Hospital de Clínicas de Porto Alegre from 2019 to 2021. Treatment times for each stage were measured, and the reasons for a delay in receiving thrombolytic therapy were evaluated. Results: A total of 256 patients received thrombolytic therapy during this period. Patients who arrived by the emergency medical service (EMS) had a lower median door-to-needle time (DNT). In the multivariable analysis, the independent predictors of DNT >60min were previous atrial fibrillation (OR 7) and receiving thrombolysis in the ED (OR 9). The majority of patients had more than one reason for treatment delay. The main reasons were as follows: delay in starting the CT scan, delay in the decision-making process after the CT scan, and delay in reducing blood pressure. Several actions were implemented during the study period. The most important factor that contributed to a decrease in DNT was starting the bolus and continuous infusion of tPA on the CT scan table (decreased the median DNT from 74 to 52, DNT ≤ 60min in 67% of patients treated at radiology service vs. 24% of patients treated in the ED). The DNT decreased from 78min to 66min in 2020 and 57min in 2021 (p = 0.01). Conclusion: Acute stroke care continued to be a priority despite the COVID-19 pandemic. The implementation of a thrombolytic bolus and the start of continuous infusion on the CT scan table was themain factor that contributed to the reduction of DNT. Continuous monitoring of service times is essential for improving the quality of the stroke center and achieving better functional outcomes for patients. [ABSTRACT FROM AUTHOR]

Published
2023
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8. Disparities in Stroke Patient-Reported Outcomes Measurement Between Healthcare Systems in Brazil

Author

Martins, Sheila Cristina Ouriques, primary, Borelli, Wyllians Vendramini, additional, Secchi, Thais Leite, additional, Mantovani, Gabriel Paulo, additional, Pille, Arthur, additional, Mora Cuervo, Daissy Liliana, additional, Carbonera, Leonardo Augusto, additional, Souza, Ana Claudia de, additional, Martins, Magda Carla Ouriques, additional, Brondani, Rosane, additional, Almeida, Andrea Garcia de, additional, Dal Pizzol, Angélica, additional, Santos, Franciele Pereira dos, additional, Alves, Ana Claudia, additional, Meier, Nathalia Soares, additional, Andrade, Guilherme Pamplona Bueno, additional, Maciel, Pedro Angst, additional, Weber, Alexandre, additional, Machado, Gustavo Dariva, additional, Parrini, Mohamed, additional, and Nasi, Luiz Antonio, additional

Published
2022
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11. Home-Based Transcranial Direct Current Stimulation for the Treatment of Symptoms of Depression and Anxiety in Temporal Lobe Epilepsy: A Randomized, Double-Blind, Sham-Controlled Clinical Trial

Author

Mota, Suelen Mandelli, primary, Amaral de Castro, Luiza, additional, Riedel, Patrícia Gabriela, additional, Torres, Carolina Machado, additional, Bragatti, José Augusto, additional, Brondani, Rosane, additional, Secchi, Thais Leite, additional, Sanches, Paulo Roberto Stefani, additional, Caumo, Wolnei, additional, and Bianchin, Marino Muxfeldt, additional

Published
2021
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12. Methylation of BDNF and SLC6A4 Gene Promoters in Brazilian Patients With Temporal Lobe Epilepsy Presenting or Not Psychiatric Comorbidities

Author

Bandeira, Isabel Cristina, primary, Giombelli, Lucas, additional, Werlang, Isabel Cristina, additional, Abujamra, Ana Lucia, additional, Secchi, Thais Leite, additional, Brondani, Rosane, additional, Bragatti, José Augusto, additional, Bizzi, Jorge Wladimir Junqueira, additional, Leistner-Segal, Sandra, additional, and Bianchin, Marino Muxfeldt, additional

Published
2021
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16. Validation of a Smartphone Application in the Evaluation and Treatment of Acute Stroke in a Comprehensive Stroke Center

Author

Martins, Sheila C.O., primary, Weiss, Gustavo, additional, Almeida, Andrea G., additional, Brondani, Rosane, additional, Carbonera, Leonardo A., additional, de Souza, Ana Claudia, additional, Martins, Magda Carla O., additional, Nasi, Guilherme, additional, Nasi, Luiz A., additional, Batista, Carlos, additional, Sousa, Fabrício B., additional, Rockenbach, Márcio A.B.C., additional, Gonçalves, Felipe M., additional, Vedolin, Leonardo M., additional, and Nogueira, Raul G., additional

Published
2020
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17. Quatro anos de experiência no tratamento trombolítico do AVC Isquêmico na cidade de Porto Alegre

Author

Martins, Sheila Cristina Ouriques, primary, Brondani, Rosane, additional, Friedrich, Maurício, additional, Araújo, Mariana Dagnino, additional, Wartchow, Adriano, additional, Passos, Paulo, additional, Manenti, Euler, additional, Jaeger, Cristiano, additional, Rech, Rafael, additional, Silveira, Daniel, additional, Ruschel, Karen, additional, Nasi, Luiz Antonio, additional, Chaves, Márcia Lorena Fagundes, additional, and Ehlers, João Arthur, additional

Published
2019
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18. Early Manipulation of Arterial Blood Pressure in Acute Ischemic Stroke (MAPAS): Results of a Randomized Controlled Trial

Author

Nasi, Luiz Antonio, primary, Martins, Sheila Cristina Ouriques, additional, Gus, Miguel, additional, Weiss, Gustavo, additional, de Almeida, Andrea Garcia, additional, Brondani, Rosane, additional, Rebello, Letícia Costa, additional, DalPizzol, Angélica, additional, Fuchs, Flávio Danni, additional, Valença, Maria Júlia Monteiro, additional, Wirth, Letícia F., additional, Nunes, Gerson, additional, and Anderson, Craig S., additional

Published
2018
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20. High risk of seizures and epilepsy after decompressive hemicraniectomy for malignant middle cerebral artery stroke

Author

Brondani, Rosane, Almeida, Andrea Garcia de, Cherubini, Pedro Abrahim, Mota, Suelen Mandelli, Antunes, Apio Cláudio Martins, and Muxfeldt, Marino Bianchin

Subjects
Stroke, Risk factors for seizures, Post-stroke epilepsy, Infarto da artéria cerebral média, Fatores de risco, Seizure prophylaxis, Convulsões, Brasil, Avaliação da deficiência, Risk factors for epilepsy, Craniectomia descompressiva
Abstract

Background: Decompressive hemicraniectomy (DHC) is a life-saving procedure for treatment of large malignant middle cerebral artery (MCA) strokes. Post-stroke epilepsy is an addition- al burden for these patients, but its incidence and the risk factors for its development have been poorly investigated. Objective: To report the prevalence and risk factors for post-stroke seizures and post-stroke epilepsy after DHC for treatment of large malignant MCA strokes in a cohort of 36 patients. Methods: In a retrospective cohort study of 36 patients we report the timing and incidence of post-stroke epilepsy. We analyzed if age, sex, vascular risk factors, side of ischemia, reperfusion therapy, stroke etiology, extension of stroke, hemorrhagic trans- formation, ECASS scores, National Institutes of Health Stroke Scale (NIHSS) scores, or modi- fied Rankin scores were risk factors for seizure or epilepsy after DHC for treatment of large MCA strokes. Results: The mean patient follow-up time was 1,086 days (SD = 1,172). Out of 36 patients, 9 (25.0%) died before being discharged. After 1 year, a total of 11 patients (30.6%) had died, but 22 (61.1%) of them had a modified Rankin score ≤4. Thirteen patients (36.1%) developed seizures within the first week after stroke. Seizures occurred in 22 (61.1%) of 36 patients (95% CI = 45.17–77.03%). Out of 34 patients who survived the acute period, 19 (55.9%) developed epilepsy after MCA infarcts and DHC (95% CI = 39.21–72.59%). In this study, no significant differences were observed between the patients who developed seizures or epi- lepsy and those who remained free of seizures or epilepsy regarding age, sex, side of stroke, presence of the clinical risk factors studied, hemorrhagic transformation, time of craniectomy, and Rankin score after 1 year of stroke. Conclusion: The incidence of seizures and epilepsy after malignant MCA infarcts submitted to DHC might be very high. Seizure might occur pre- cociously in patients who are not submitted to anticonvulsant prophylaxis. The large stroke volume and the large cortical ischemic area seem to be the main risk factors for seizure or epilepsy development in this subtype of stroke.

Published
2017

21. Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack

Author

Johnston, S Claiborne, Amarenco, Pierre, Albers, Gregory W, Denison, Hans, Easton, J Donald, Evans, Scott R, Held, Peter, Jonasson, Jenny, Minematsu, Kazuo, Molina, Carlos A, Wang, Yongjun, Wong, K S Lawrence, Ameriso, Sebastiá F, Donnan, Geoffrey, Lemmens, Robin, Massaro, Ayrton, Titianova, Ekaterina, Hill, Michael D, Lavados, Pablo, Skoloudik, David, Röther, Joachim, Norbert, Szegedi, Agnelli, Giancarlo, Bornstein, Natan, Tanahashi, Norio, Góngora, Angel Arauz, Pretell, Edwin, San Jose, Maria Cristina Z, Czlonkowska, Anna, Bajenaru, Ovidiu, Stakhovskaya, Ludmila, Brozman, Miroslav, Kim, Jong-Sung, Wahlgren, Nils, Michel, Patrik, Lee, Tsong Hai, Suwanwela, Nijasri Charnnarong, Kutluk, Kursad, Moskovko, Sergii, Kasner, Scott, Laskowitz, Daniel, Clark, Wayne, Nguyen, Huy Thang, Ameriso, Sebastián F, Ameriso, Sebastian, Lepera, Sandra, Romano, Marina, Paulon, David, Ioli, Pablo, Zurru, Cristina, Bruera, Guadalupe, Jure, Lorena, Klein, Francisco, Povedano, Guillermo, Levi, Christopher, Phan, Thanh, Markus, Romesh, Anderson, Craig, Sabet, Arman, Davis, Stephen, Lee, Andrew, Kleinig, Timothy, Wong, Andrew, Krause, Martin, Jannes, Jim, Wijeratne, Tissa, Hemelsoet, Dimitri, Peeters, André, Tack, Philippe, Vanacker, Peter, Laloux, Patrice, Van Landegem, William, Vanhooren, Geert, Desfontaines, Philippe, Van Orshoven, Marc, Oliveira, Fabio, Friedrich, Mauricio, Brondani, Rosane, Gagliardi, Rubens, Fabio, Soraia, Dracoulakis, Marianna, Bazan, Rodrigo, Marrone, Luiz, Pontes Neto, Octavio, Silva, Gisele, Kowacs, Pedro, Stamenova, Paraskeva, Daskalov, Marin, Staikov, Ivan, Baldaranov, Dimo, Maslarov, Dimitar, Lilovski, Hristo, Petkov, Plamen, Petrova, Neli, Mavrov, Radoslav, Markova, Veska, Petrova, Valeria, Beleva, Tanya, Kralev, Borislav, Sotirov, Nikolay, Lekova, Veska, Hristov, Dimcho, Ermenkova, Vera, Mateev, Lyudmil, Mitkova, Rumeliya, Haralanov, Liybomir, Ikonomov, Rosen, Mihailova, Margarita, Georgiev, Ivan, Shuaib, Ashfaq, Hachinski, Vladimir, Boulanger, Jean-Martin, Mann, Sharan, Hassan, Ayman, Mackey, Ariane, Menon, Bijoy, Minuk, Jeffrey, Siddiqui, Muzaffar, Eustace, Marsha, Vieira, Lucia, Selchen, Daniel, Beaudry, Michel, Stotts, Grant, Castro, Angel, Gasic, Kristo, Rivas, Rodrigo, Sanchez, Pablo, Roldan, Andres, Grossmann, Ingrid, Figueroa, Christian, Li, Jimei, Xu, Xiaolin, Chen, Huisheng, Li, Xiaohong, Yang, Yi, Zhang, Chunsheng, Wang, Baojun, Li, Guanglai, Wang, Dong, Lin, Hong, Tang, Yamei, Xu, Anding, Wang, Yanjiang, Hong, Wenke, Song, Zhi, Zhang, Xu, Jin, Xiaoping, Xu, Yun, Yan, Fuling, Zheng, Weihong, Wang, Xiaoping, Dong, Qiang, Zhao, Zhongxin, Zhang, Baorong, Zhong, Wangtao, Wen, Guoqiang, Xu, Jun, Li, Guozhong, Dong, Xueshuang, Tian, Xiangyang, Zhang, Zhaohui, Xu, En, Liu, Kaixiang, Chen, Jun, Skoda, Ondrej, Ehler, Edvard, Vaclavik, Daniel, Sanak, Daniel, Klimosova, Sylva, Vitkova, Eva, Fiksa, Jan, Mikulik, Robert, Neumann, Jiri, Plny, Richard, Leys, Didier, Sibon, Igor, Mas, Jean-Louis, Alamowitch, Sonia, Pico, Fernando, Hosseini, Hassan, Mahagne, Marie-Hélène, Touze, Emmanuel, Vadot, Wilfried, Vannier, Stéphane, Nighoghossian, Norbert, Samson, Yves, Garnier, Pierre, Ellie, Emmanuel, Guillon, Benoît, Timsit, Serge, Giroud, Maurice, Philippeau, Frédéric, Bagan-Triquenot, Aude, Wolff, Valérie, Raposo, Nicolas, Obadia, Michel, Debiais, Severine, Grimaud, Jérôme, Illouz, Stéphane, Smadja, Didier, Urbanczyk, Cédric, Berrouschot, Jörg, Weimar, Christian, Gahn, Georg, Soda, Hassan, Klimpe, Sven, Nabavi, Darius, Glahn, Jörg, Köhrmann, Martin, Krause, Lars, Terborg, Christoph, Urban, Peter, Steiner, Thorsten, Ferbert, Andreas, Dziewas, Rainer, Seidel, Günter, Thomalla, Götz, Wong, Ka Sing Lawrence, Li, Richard, Fong, Wing Chi, Cheung, Raymond, Szegedi, Norbert, Pozsegovits, Krisztián, Valikovics, Attila, Pánczél, Gyula, Rózsa, Csilla, Németh, László, Diószeghy, Péter, Óváry, Csaba, Csányi, Attila, Kerényi, Levente, Nagy, Valéria, Komoly, Sámuel, Bereczki, Dániel, Molnár, Sándor, Kondákor, István, Tanne, David, Raphaeli, Guy, Telman, Gregory, Leker, Ronen, Lampl, Yair, Corea, Francesco, Ricci, Stefano, Guidetti, Donata, Malferrari, Giovanni, Marcheselli, Simona, Micieli, Giuseppe, Zini, Andrea, Di Lazzaro, Vincenzo, Gandolfo, Carlo, Salmaggi, Andrea, Tassi, Rossana, Rasura, Maurizia, Orlandi, Giovanni, Comi, Giancarlo, Mancuso, Michelangelo, Delodovici, Marialuisa, Bovi, Paolo, Consoli, Domenico, Utsugisawa, Kimiaki, Fujita, Tsuneo, Kurihara, Hideyuki, Maruki, Chikashi, Hayashi, Takeshi, Ogiichi, Tsuneaki, Kumagai, Morio, Takenaka, Katsunobu, Toyoda, Kazunori, Takamatsu, Kazuhiro, Ogami, Ryo, Kin, Shigenari, Aoki, Takeshi, Takizawa, Katsumi, Omori, Shigehiro, Umezawa, Takehiko, Toba, Yasuyuki, Nonoyama, Yutaka, Nakagawa, Hidemitsu, Naka, Takashi, Morimoto, Masanori, Matsumoto, Shuichi, Hitotsumatsu, Tsutomu, Shingaki, Tatsuya, Okuda, Satoshi, Ota, Mamoru, Sakai, Nobuyuki, Yamada, Takeshi, Niwa, Jun, Fujita, Hitoshi, Moriki, Akihito, Yoshino, Kimihiro, Fukushima, Yoshihisa, Mori, Takahisa, Sato, Atsushi, Kusano, Yoshikazu, Kubo, Michiya, Yamazaki, Masashi, Ooasa, Takao, Nishizaki, Takafumi, Kitagawa, Naoki, Yasaka, Masahiro, Manabe, Yasuhiro, Yoshioka, Akira, Ishihara, Masayuki, Kagawa, Takato, Ichihashi, Toshikazu, Matsuoka, Hideki, Ito, Yasuhiro, Yamasaki, Masahiro, Takaba, Hitonori, Saito, Hisatoshi, Sato, Masahiro, Fukuda, Kazumasa, Endo, Sumio, Kidooka, Minoru, Umemura, Toshitaka, Kikkawa, Yuriko, Toru, Shuta, Yamada, Kentaro, Sakai, Hideki, Asari, Jun, Ezura, Masayuki, Nitta, Hisashi, Nagano, Keiko, Ochiai, Jun, Sakai, Keiichi, Kobayashi, Yasutaka, Yoshii, Yasuhiro, Miake, Hirotomo, Takita, Tomohiro, Taniguchi, Hidekazu, Kuroki, Kazuhiko, Mizota, Takamitsu, Yamamoto, Kenichi, Nakane, Hiroshi, Iwanaga, Takeshi, Chiba, Kei, Yoshimoto, Tetsuyuki, Torii, Tsuyoshi, Kitagawa, Takeo, Takashima, Hiroshi, Shirasaki, Naoki, Dehara, Makoto, Wada, Naomichi, Hamada, Kensuke, Kato, Noriyuki, Go, Yoshinori, Izumi, Ichiro, Ninomiya, Hirotomo, Kumai, Junichiro, Nakajima, Yoshikazu, Kaku, Yasuhiko, Isayama, Yukihiro, Kawanishi, Masahiro, Noda, Shinya, Yamamoto, Kazuhide, Hazama, Takanori, Takahashi, Hiroshi, Tanaka, Yohei, Hata, Takashi, Kazekawa, Kiyoshi, Furui, Eisuke, Hondo, Hideki, Sato, Nobuyuki, Kusunoki, Katsusuke, Nanri, Kazunori, Abe, Satoshi, Sasaoka, Noboru, Kuroyanagi, Takayuki, Suzuki, Hisahiko, Fukuyama, Kouzou, Nakahara, Kimihiro, Gongora, Fernando, Brito, Carlos Cantú, Careaga, Jorge Villarreal, Alfaro, Rosalia Vazquez, Leytte, Geronimo Aguayo, Berrospi, Percy, Chavez, Carlos, Rodriguez, Liliana, Custodio, Nilton, Castañeda, Cesar, Perez, Julio, Marquez, Sandra Vargas, San Jose, Maria Cristina, Baroque, Alejandro, Collantes, Ma Epifania, Aquino, Abdias, Díaz, Alejandro, Roxas, Artemio, Lokin, Johnny, Advincula, Joel, Calderon, Emerito, Navarro, Jose, Hiyadan, John, Surdilla, Arturo, Ryglewicz, Danuta, Krychowiak, Grzegorz, Fryze, Waldemar, Sobolewski, Piotr, Nowak, Ryszard, Fiszer, Urszula, Papierowska, Beata, Zieli?ska-Turek, Justyna, Lasek-Bal, Anetta, Ko?odziejska, Ewa, Kami?ska, Anna, Adamkiewicz, Bo?ena, Tutaj, Andrzej, Szkopek, Dorota, Musiatowicz, Krzysztof, B?k, Zbigniew, Brzozowski, S?awomir, Brola, Waldemar, Ferens, Antoni, Zalisz, Marek, Rejdak, Konrad, Rudzi?ska, Monika, Panea, Cristina, Simu, Mihaela, Balasa, Rodica, Cuciureanu, Iulian, Popescu, Bogdan, Sabau, Monica, Roman-Filip, Corina, Stakhovskaya, Liudmila, Pimenov, Leonid, Gekht, Alla, Milto, Anna, Shchukin, Ivan, Parfenov, Vladimir, Arkhipov, Mikhail, Vishneva, Elena, Sokolova, Nadezhda, Bogdanov, Enver, Esin, Radiy, Khasanova, Dina, Golikov, Konstantin, Melnikova, Elena, Zaslavskiy, Leonid, Voznyuk, Igor, Nazarov, Alexander, Akhmadeeva, Leila, Iakupova, Aida, Shamalov, Nikolay, Belskaya, Galina, Chuprina, Svetlana, Denisova, Olga, Drozdova, Ekaterina, Karakulova, Yuliya, Sholomov, Ilya, Spirin, Nikolay, Vostrikova, Elena, Mordvintseva, Elena, Grigoryeva, Vera, Zateyshchikov, Dmitry, Gorbachev, Vladimir, Chefranova, Zhanna, Dudarev, Mikhail, Nilk, Rostislav, Rozhdestvenskiy, Alexey, Gurcik, Ladislav, Dvorak, Miloslav, Krastev, Georgi, Kurca, Egon, Vyletelka, Juraj, Kim, Jong Sung, Bae, Hee-Joon, Kim, Yong-Won, Kim, Joon-Tae, Cha, Jae-Kwan, Nam, Hyo Suk, Chang, Dae-Il, Lee, Yong-Seok, Oh, Kyungmi, Yu, Sung-Wook, Sohn, Sung-Il, Lee, Jun, Cho, Han Jin, Kim, Eung-Gyu, Rha, Joung-Ho, Kim, Seo Hyun, Cateriano, Carlos Molina, Leal, Joaquín Serena, Mora, José Vivancos, Yañez, Manuel Rodríguez, González, Jaume Roquer, García, Francisco Purroy, Cortina, Meritxell Gomis, Vallejo, Jaime Masjuan, Lara, Juan Arenillas, Martín, Tomás Segura, Herrero, José Antonio Egido, Ferrairó, Jose Ignacio Tembl, Culleré, Jaime Gállego, Álvarez, Francisco Moniche, Steinberg, Anna, Callander, Margarita, Laska, Ann Charlotte, Bokemark, Lena, Mooe, Thomas, Käll, Tor-Björn, Welin, Lennart, Sjöblom, Lars, Hambraeus, Joakim, Teichert, Jörg, Wannberg, Hans, Sanner, Johan, Ramströmer, Bo, Ziedén, Bo, Hau, Stefan Olsson, Gustafsson, Claes, Kahles, Timo, Lyrer, Philippe, Arnold, Marcel, Liesch, Martin, Medlin, Friedrich, Cereda, Carlo, Kägi, Georg, Luft, Andreas, Carrera, Emmanuel, Lee, Tsong-Hai, Po, Helen L, Chern, Chang-Ming, Lien, Li-Ming, Chan, Lung, Liu, Chung-Hsiang, Wu, Shey-Lin, Lee, Jiann-Der, Chen, Chih-Hung, Lin, Huey-Juan, Lin, Ruey-Tay, Chen, Wei-Hsi, Sun, Yu, Tantirittisak, Tasanee, Muengtaweepongsa, Sombat, Nilanont, Yongchai, Tiamkao, Somsak, Udommongkol, Chesda, Watcharasaksilp, Kanokwan, Jantararotai, Witoon, Sirin, Hadiye, Ince, Birsen, Asil, Talip, Arsava, Murat, Incesu, Tulay Kurt, Tireli, Hulya, Kucukoglu, Hayriye, Ak, Fikri, Unal, Ali, Ozturk, Serefnur, Uzuner, Nevzat, Chmyr, Galyna, Lebedynets, Volodymyr, Nikonov, Vadym, Shulga, Lyudmyla, Smolanka, Volodymyr, Khavunka, Marta, Yavorska, Valentyna, Tomakh, Nataliya, Kozyolkin, Olexandr, Litovaltseva, Galyna, Lansberg, Maarten, Bernstein, Richard, Brown, David, Dissin, Jonathan, Graffagnino, Carmelo, Harris, Jonathan, Hicks, William, Katzan, Irene, Kramer, Jeffrey, Willey, Joshua, Silliman, Scott, Starkman, Sidney, Thaler, David, Tremwel, Margaret, Concha, Mauricio, Rajamani, Kumar, Dandapani, Bhuvaneswari, Silver, Brian, Deal, Nathan, Chang, Ira, Hassan, Ameer, Rudolph, Steven, Fischer, Kenneth, Kirshner, Howard, Logan, William, Mallenbaum, Sidney, Hefzy, Hebah, Latorre, Julius, Levine, Steven, Ciabarra, Anthony, Dafer, Rima, Anyanwu, Benjamin, Cherian, Laurel, Panezai, Spozhmy, Khanna, Anna, Dodds, Jodi, Torbey, Michel, Gebel, James, Woo, Henry, Chiu, David, Androulakis, Xiao, Burgin, William, Pineda, Maria, Yilmaz, Engin, Altafullah, Irfan, Boutwell, Christine, Cruz-Flores, Salvador, Sapkota, Biggya, Fayad, Pierre, Jacoby, Michael, Rafiq, Shahid, Salgado, Efrain, Lafranchise, Eugene, Felton, Warren, Madhavan, Ramesh, Zaidat, Osama, Pieper, Connie, Riviello, Ralph, Burnett, Aaron, Fischer, Michelle, Gentile, Nina, Calder, Christopher, Dietrich, Dennis, Cross, Jonathan, Blankenship, Larry, Montoya, Liliana, Grogan, Wendell, Young, Mark, Khan, Farrukh, Campbell, Duane, Daboul, Nizar, Espinoza, Andrey, Cullis, Paul, Concepcion, Gilberto, Wulff, John, Afzal, Haider, Jaffrani, Naseem, Reiter, William, Arshad, Tamjeed, Lukovits, Timothy, Welker, James, Chang, Fen Lei, Badruddin, Aamir, Babikian, Viken, Menon, Ravi, Sander, James, Springer, Mellanie, Nanda, Ashish, Mas, Luis, Rajan, Raj, Silverman, Bruce, Huang, David, Carpenter, David, Clark, Joni, Ching, Marilou, Santhakumar, Sunitha, Gould, Jeffrey, Bansal, Vibhav, Vidal, Gabriel, Mikesell, Timothy, Brick, John, French, William, Shah, Qaisar, Holmstedt, Christine, Ishag-Osman, Nadir, Kostis, John, Shehadeh, Abbas, Sethi, Pramodkumak, Imam, Asher, Mccomas, Carl, Tran, Duc, Gebreyohanns, Mehari, Wiseman, Brian, Malik, Maheen, Schwarcz, Aron, Altschul, Dorothea, Castaldo, John, Alshekhlee, Amer, Gancher, Stephen, Krish, Nagesh, Nguyen-Huynh, Mai, Tremwell, Margaret, Sharma, Jitendra, Lee, Lance, Neil, William, Siddiqui, Fazeel, Malek, Ali, Romero, Charles, Huy, Thang Nguyen, Hoang, Hoa, Nguyen, Thang, Nguyen, Anh, Nguyen, Hung, Dean's Office (DO - AUSTIN), University of Texas at Austin [Austin], Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Bichat - Claude Bernard, Stanford Stroke Center, Stanford University Medical Center, AstraZeneca, Harvard T.H. Chan School of Public Health, National Cerebral and Cardiovascular Center (NCCC - OSAKA), Osaka University [Osaka], Stroke Unit (SU - BARCELONE), Vall d'Hebron University Hospital [Barcelona], Department of Neurology (Dep Neuro - BEIJING), Tiantan Hospital, Department of Medicine and Therapeutics [Hong Kong], The Chinese University of Hong Kong [Hong Kong], Murdoch University, Service de Neurologie [Brest], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Ticagrelor, Adenosine, Medizin, Aged, Aspirin, Double-Blind Method, Female, Hemorrhage, Humans, Ischemic Attack, Transient, Kaplan-Meier Estimate, Middle Aged, Platelet Aggregation Inhibitors, Purinergic P2Y Receptor Antagonists, Stroke, Medicine (all), 030204 cardiovascular system & hematology, Stringa autori originale: Johnston SC, Easton JD, 0302 clinical medicine, Myocardial infarction, Ischemic Attack, Transient, General Medicine, Clopidogrel, Denison H, 3. Good health, Minematsu K, Wang Y, SOCRATES Steering Committee and Investigators. - Free full-text sul sito dell'editore, Anesthesia, Platelet aggregation inhibitor, Evans SR, medicine.drug, Stringa autori originale: Johnston SC, Amarenco P, Albers GW, Denison H, Easton JD, Evans SR, Held P, Jonasson J, Minematsu K, Molina CA, Wang Y, Wong KS, Ischemia, Loading dose, Molina CA, 03 medical and health sciences, medicine, business.industry, Jonasson J, medicine.disease, Albers GW, Amarenco P, Held P, Wong KS, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Ticagrelor may be a more effective antiplatelet therapy than aspirin for the prevention of recurrent stroke and cardiovascular events in patients with acute cerebral ischemia.; We conducted an international double-blind, controlled trial in 674 centers in 33 countries, in which 13,199 patients with a nonsevere ischemic stroke or high-risk transient ischemic attack who had not received intravenous or intraarterial thrombolysis and were not considered to have had a cardioembolic stroke were randomly assigned within 24 hours after symptom onset, in a 1:1 ratio, to receive either ticagrelor (180 mg loading dose on day 1 followed by 90 mg twice daily for days 2 through 90) or aspirin (300 mg on day 1 followed by 100 mg daily for days 2 through 90). The primary end point was the time to the occurrence of stroke, myocardial infarction, or death within 90 days.; During the 90 days of treatment, a primary end-point event occurred in 442 of the 6589 patients (6.7%) treated with ticagrelor, versus 497 of the 6610 patients (7.5%) treated with aspirin (hazard ratio, 0.89; 95% confidence interval [CI], 0.78 to 1.01; P=0.07). Ischemic stroke occurred in 385 patients (5.8%) treated with ticagrelor and in 441 patients (6.7%) treated with aspirin (hazard ratio, 0.87; 95% CI, 0.76 to 1.00). Major bleeding occurred in 0.5% of patients treated with ticagrelor and in 0.6% of patients treated with aspirin, intracranial hemorrhage in 0.2% and 0.3%, respectively, and fatal bleeding in 0.1% and 0.1%.; In our trial involving patients with acute ischemic stroke or transient ischemic attack, ticagrelor was not found to be superior to aspirin in reducing the rate of stroke, myocardial infarction, or death at 90 days. (Funded by AstraZeneca; ClinicalTrials.gov number, NCT01994720.).

Published
2016
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22. Abstract TP312: Assessment of the Data Collection Strategies for Stroke Patient-centered Outcomes: Implementation of the International Consortium for Health Outcomes in Brazil

Author

Martins, Sheila C, primary, Martins, Magda C, additional, Carbonera, Leonardo A, additional, Souza, Ana C, additional, Portal, Marcelle, additional, Martin, Kelin, additional, Rodrigues, Gabriel, additional, Cuervo, Liliana M, additional, Brondani, Rosane, additional, Almeida, Andrea G, additional, Weiss, Gustavo, additional, Parrini, Mohamed, additional, and Nasi, Luiz A, additional

Published
2018
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23. Abstract TP314: Comparison of Patient-centered Outcome Measures of the International Consortium for Health Outcomes Measurements (ICHOM) Between Private and Public Healthcare System in Brazil

Author

Martins, Sheila C, primary, Souza, Ana C, additional, Carbonera, Leonardo A, additional, Martins, Magda C, additional, Martin, Kelin, additional, Portal, Marcelle, additional, Parrini, Mohamed, additional, Almeida, Andrea G, additional, Brondani, Rosane, additional, Weiss, Gustavo, additional, and Nasi, Luiz A, additional

Published
2018
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25. What neuropsychological functions best discriminate performance in adults post-stroke?

Author

Rodrigues, Jaqueline de Carvalho, Machado, Wagner de Lara, da Fontoura, Denise Ren, Almeida, Andrea Garcia, Brondani, Rosane, Martins, Sheila Ouriques, Ruschel Bandeira, Denise, and Salles, Jerusa Fumagalli de

Subjects
NEUROPSYCHOLOGICAL tests, ADULTS, STROKE patients, COGNITION disorders
Abstract

This study aimed to develop a short version of an instrument to detect cognitive impairment in stroke patients, investigate which cognitive dimensions best discriminate between stroke patients and healthy adults and to graphically analyze the relationships among the neuropsychological variables and groups. This pilot study included 94 adults (49 post-stroke and 45 neurologically healthy) who answered the Brief Neuropsychological Assessment Battery NEUPSILIN for patients with expressive aphasia (NEUPSILIN-Af) to assess orientation, perception, memory, praxis, executive functions, oral language, and academic achievement (written language and arithmetic). The IRT Rasch model for dichotomous data indicated the exclusion of items that could not be used to discriminate performances. ROC curves indicated that only the orientation, oral language, academic achievement, and executive function dimensions could be used to differentiate between the clinical and healthy groups. Graphical analysis indicated that independently of the relation among variables, orientation and executive functions tasks are essentials in the neuropsychological assessments. This study contributes to the development of specific and sensitive neuropsychological instruments to assess stroke patients and to better understand the common deficits present in this clinical population. [ABSTRACT FROM AUTHOR]

Published
2019
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26. Crises epilépticas e epilepsia após acidente vascular cerebral isquêmico com uso de terapia de reperfusão (rt-PA) ou hemicraniectomia descompressiva

Author

Brondani, Rosane and Bianchin, Marino Muxfeldt

Subjects
Acidente vascular cerebral, Risk factors for seizures, Stroke outcome, Post-stroke epilepsy, Artéria cerebral média, Reperfusão, Malignant middle cerebral artery, Decompressive hemicraniectomy, Reperfusion therapy, Risk factors for epilepsy, Acute seizures, Craniectomia descompressiva, Epilepsia
Abstract

Base teórica: O Acidente Vascular Cerebral (AVC) é a causa mais comum de novos diagnósticos de epilepsia no idoso. Embora a epilepsia pós-AVC seja um fenômeno clínico reconhecido há muito tempo, seguem muitas questões não resolvidas. Além disso, nas últimas duas décadas, o tratamento do AVC isquêmico sofreu mudanças radicais com a introdução da trombólise e da hemicraniectomia descompressiva (HD) para o tratamento do infarto maligno de artéria cerebral média (ACM). As consequências destas duas novas abordagens terapêuticas nas características da epilepsia pós-AVC ainda são pouco exploradas. Objetivo: Estudar as características e estimar fatores de risco para as crises epilépticas ou a epilepsia pós-AVC em pacientes submetidos ao tratamento agudo (Estudo 1) ou HD para infarto maligno de ACM (Estudo 2). Métodos: O estudo 1 é uma coorte de 153 pacientes submetidos a trombólise. Variáveis estudadas incluiram fatores de risco para o AVC e variáveis associadas ao AVC isquêmico agudo e trombólise. Utilizamos a análise de regressão de Cox para o estudo das variáveis que se associaram de forma independente com crises epilépticas, epilepsia pós-AVC e o desfecho do AVC. O estudo 2 é também uma coorte que retrospectivamente avaliou 36 pacientes com infarto maligno de ACM tratados com HD. Tempo, incidência e fatores de risco para crises epilépticas e desenvolvimento de epilepsia foram analisados. Resultados: Estudo 1: 74 pacientes (48,4%) eram mulheres; média de idade foi 67,2 anos (DP=13,1). Média do NIHSS na chegada foi 10,95 (DP=6,25) e 2,09 (DP=3,55) após 3 meses. Transformação hemorrágica ocorreu em 22 (14,4%) dos pacientes. Foi considerado desfecho bom classificação na escala modificada de Rankin (mRS) 0-1, sendo encontrado em 87 (56,9%) dos pacientes. Vinte e um pacientes (13,7%) tiveram crises epilépticas e 15 (9,8%) desenvolveram epilepsia após a trombólise. Crises epilépticas foram associadas de forma independente com transformação hemorrágica e desfecho não favorável (mRS ≥ 2) em três meses após o AVC. Transformação hemorrágica e mRS ≥ 2 avaliados em 3 meses, associaram-se de forma independente com epilepsia pós-AVC. Crises epilépticas surgiram como um fator de risco independente para desfecho pobre. Estudo 2. A média de seguimento dos pacientes foi de 1.086 (DP= 1.172) dias. Nove pacientes morreram antes de receberem alta hospitalar e no período de um ano, 11 pacientes haviam morrido. Quase 60% alcançaram mRS ≤ 4. Treze pacientes desenvolveram crises dentro da primeira semana após o AVC. No total, crises epilépticas ocorreram em 22 (61%) dos 36 pacientes. Dezenove pacientes (56%) dos 34, sobreviveram ao período agudo e desenvolveram epilepsia após infarto da ACM e HD. Questionamos aos pacientes ou responsáveis se eles se arrependeram de terem autorizado a HD no momento do AVC. Também foi perguntado se eles autorizariam a HD novamente. Trinta e dois (89%) não se arrependeram de ter autorizado a HD no momento do infarto agudo da ACM, e autorizaria novamente em retrospecto. Conclusão: Confirmamos que as frequências de crises ou epilepsia pós-AVC e trombolítico são comparáveis com as frequências das décadas da era pré-trombólise e confirmamos a alta incidência de crises epilépticas e epilepsia após infartos malignos de ACM submetidos a HD. Em nosso estudo, as crises epilépticas associaram-se de forma independente com pior prognóstico após terapia trombolítica. Background: The most common cause of newly diagnosed epilepsies in the elderly is stroke. Although post-stroke epilepsy is a well-studied stroke complication, many questions remain unsolved. In addition, during the past two decades, the treatment of stroke has changed dramatically with the introduction of thrombolysis for treatment of acute ischemic stroke (AIS) and decompressive hemicraniectomy (DHC) for malignant middle cerebral artery infarction (MCA). The consequences of these two new therapeutic approaches for characteristics of post-stroke epilepsy remains poorly explored. Objective: To study characteristics and estimate risk factors for acute seizures or post-stroke epilepsy in patients submitted to thrombolysis for treatment of acute stroke (Study 1) or DHC for malignant MCA infarction. Methods: Study 1 is a cohort study of 153 patients submitted to thrombolysis. Variables studied included risk factors for stroke, and variables related to acute stroke and thrombolysis. Variables independently associated with seizures, pos-stroke epilepsy or stroke outcome were defined using Cox regression analysis. Study 2 is also a cohort study that retrospectively assessed 36 patients with malignant stroke of the MCA submitted to DHC. Timing, incidence and plausible risk factors for seizure and epilepsy development were analyzed in these patients. Results: Study 1. Seventy-four patients (48.4%) were female; mean age of patients was 67.2 years-old (SD=13.1). Initial NIHSS mean score was 10.95 (SD=6.25) and 2.09 (SD=3.55) after three months. Hemorrhagic transformation occurred in 22 (14.4%) patients. A good outcome, as defined by a modified Rankin Scale (mRS) of 0-1, was observed in 87 (56.9%) patients. Twenty one (13.7%) patients had seizures and 15 (9.8%) patients developed epilepsy after thrombolysis. Seizures were independently associated with hemorrhagic transformation and with mRS ≥ 2 three months after stroke. Hemorrhagic transformation and unfavorable outcome, as measured by mRS ≥ 2 after three months, were variables independently associated with post-stroke epilepsy. Seizures emerged as an independent factor for poor outcome in stroke thrombolysis. Study 2. Mean patient follow-up time was of 1.086 (SD=1.172) days. Nine patients died before being discharged and after one year eleven patients died. Almost 60% had the modified Rankin score ≤ 4. Thirteen patients developed seizures within the first week after stroke. In total, seizures occurred in 22 (61%) of 36 patients. Nineteen patients (56%) out of 34 patients who survived the acute period developed epilepsy after MCA infarcts and DHC. Also, we asked patients or the person responsible for them whether they regretted, in retrospect, having authorized DHC at the time of the stroke. It was also asked whether they would authorize DHC again. Thirty- two (89%) did not regret having authorized DHC at the time of acute MCA infarct, and would authorize DHC again in retrospect. Conclusion: We confirm that seizures or post-stroke epilepsy rates after thrombolysis are comparable with rates from pre-thrombolysis decades and a high incidence of seizures and epilepsy after malignant MCA infarcts submitted to DHC. In our study, seizures were an independent risk factor associated with worst outcome after thrombolysis therapy.

Published
2015

28. Evaluación neuropsicológica breve de adultos post-accidente cerebrovascular en el hemisferio izquierdo

Author

PAWLOWSKI, JOSIANE, DE CARVALHO RODRIGUES, JAQUELINE, OURIQUES MARTINS, SHEILA CRISTINA, BRONDANI, ROSANE, FAGUNDES CHAVES, MÁRCIA LORENA, PAZ FONSECA, ROCHELE, and RUSCHEL BANDEIRA, DENISE

Subjects
neuropsychological assessment, evaluación neuropsicológica, avaliação neuropsicológica, accidente vascular cerebral, hemisfério esquerdo, hemisferio izquierdo, acidente vascular cerebral, stroke, left hemisphere
Abstract

A avaliação neuropsicológica busca identificar funções cognitivas deficitárias e preservadas para auxiliar no diagnóstico, no prognóstico e na reabilitação do paciente. No Brasil, o AVC é uma das principais causas de internações e a primeira causa de mortalidade e incapacitação. O AVC em hemisfério esquerdo (HE) está associado a diferentes graus de prejuízo de linguagem e a outros prejuízos cognitivos, por exemplo, na memória. Objetivou-se comparar o desempenho em tarefas neuropsicológicas breves de pacientes pós-AVC de HE, na ausência de quadro afásico moderado ou grave, com controles saudáveis. Uma lista de 135 pacientes foi selecionada com base em critérios de inclusão. Participaram do estudo 15 pacientes com lesão vascular esquerda, emparelhados por sexo, idade e escolaridade a 30 adultos neurologicamente saudáveis. Os dados resultantes da aplicação do Instrumento de Avaliação Neuropsicológica Breve Neupsilin foram analisados com o Teste não paramétrico U de Mann-Withney. Os adultos com AVC de HE apresentaram redução significativa no desempenho quando comparados a controles saudáveis em linguagem, memória de trabalho e praxia ideomotora, resultados também encontrados em outros estudos com pacientes com lesão vascular no HE. The neuropsychological assessment investigates cognitive deficits to improve the diagnosis, the prognosis and the rehabilitation of patients. In Brazil, stroke is a major cause of hospitalization and the leading cause of mortality and disability. The stroke in the left hemisphere (LH) is associated with different degrees of loss of language and other cognitive impairments, for example, in the memory. We compared the performance in brief neuropsychological tasks of the left hemisphere poststroke patients, without moderate or severe aphasia, with healthy controls. A list of135 patients was selected based on inclusion criteria. The study included 15 patients with left stroke, paired by sex, age and education to 30 neurologically healthy adults. The data resulting from application of the Neupsilin Brief Neuropsychological Assessment Instrument were analyzed with the nonparametric Mann-Whitney U. Adults with LH stroke showed a significant reduction in performance when compared to healthy controls on language, working memory and ideomotor praxis, results also found in other studies of patients with left hemisphere stroke. La evaluación neuropsicológica investiga los déficits cognitivos para mejorar el diagnóstico, el pronóstico y la rehabilitación de los pacientes. En Brasil, el accidente cerebrovascular es una causa importante de hospitalización y la principal causa de mortalidad y discapacidad. El accidente cerebrovascular en el hemisferio izquierdo (HI) se asocia con diferentes grados de pérdida de lenguaje y otros deterioros cognitivos, por ejemplo, en la memoria. Se comparó el rendimiento neuropsicológico en pruebas breves de pacientes sin afasia moderada o grave, después del accidente cerebrovascular en hemisferio izquierdo, con los controles sanos. Una lista de 135 pacientes se seleccionaron sobre la base de criterios de inclusión. El estudio incluyó a 15 pacientes con accidente cerebrovascular izquierdo, pareados por sexo, edad y educación a 30 adultos neurológicamente sanos. Los datos resultantes de la aplicación de la prueba breve de evaluación neuropsicológica Neupsilin fueron analizados con el test no paramétrico U de Mann-Whitney. Fue encontrada una reducción significativa en el rendimiento de los pacientes con accidente vascular en HI en comparación con los controles sanos en el lenguaje, la memoria de trabajo y de la praxis ideomotora. Los resultados también se encuentran en otros estudios de pacientes con accidente vascular en HI.

Published
2013

30. Early Mobilization in Ischemic Stroke: A Pilot Randomized Trial of Safety and Feasibility in a Public Hospital in Brazil

Author

Poletto, Simone Rosa, primary, Rebello, Letícia Costa, additional, Valença, Maria Júlia Monteiro, additional, Rossato, Daniele, additional, Almeida, Andrea Garcia, additional, Brondani, Rosane, additional, Chaves, Márcia Lorena Fagundes, additional, Nasi, Luiz Antônio, additional, and Martins, Sheila Cristina Ouriques, additional

Published
2015
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31. Brief neuropsychological assessment of adults post-stroke in the left hemisphere

Author

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Pawlowski, Josiane, Rodrigues, Jaqueline de Carvalho, Martins, Sheila Cristina Ouriques, Brondani, Rosane, Chaves, Márcia Lorena Fagundes, Fonseca, Rochele Paz, Bandeira, Denise Ruschel, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Pawlowski, Josiane, Rodrigues, Jaqueline de Carvalho, Martins, Sheila Cristina Ouriques, Brondani, Rosane, Chaves, Márcia Lorena Fagundes, Fonseca, Rochele Paz, and Bandeira, Denise Ruschel

Abstract

The neuropsychological assessment investigates cognitive deficits to improve the diagnosis, the prognosis and the rehabilitation of patients. In Brazil, stroke is a major cause of hospitalization and the leading cause of mortality and disability. The stroke in the left hemisphere (LH) is associated with different degrees of loss of language and other cognitive impairments, for example, in the memory. We compared the performance in brief neuropsychological tasks of the left hemisphere poststroke patients, without moderate or severe aphasia, with healthy controls. A list of 135 patients was selected based on inclusion criteria. The study included 15 patients with left stroke, paired by sex, age and education to 30 neurologically healthy adults. The data resulting from application of the Neupsilin Brief Neuropsychological Assessment Instrument were analyzed with the nonparametric Mann-Whitney U. Adults with LH stroke showed a significant reduction in performance when compared to healthy controls on language, working memory and ideomotor praxis, results also found in other studies of patients with left hemisphere stroke, La evaluación neuropsicológica investiga los déficits cognitivos para mejorar el diagnóstico, el pronóstico y la rehabilitación de los pacientes. En Brasil, el accidente cerebrovascular es una causa importante de hospitalización y la principal causa de mortalidad y discapacidad. El accidente cerebrovascular en el hemisferio izquierdo (HI) se asocia con diferentes grados de pérdida de lenguaje y otros deterioros cognitivos, por ejemplo, en la memoria. Se comparó el rendimiento neuropsicológico en pruebas breves de pacientes sin afasia moderada o grave, después del accidente cerebrovascular en hemisferio izquierdo, con los controles sanos. Una lista de 135 pacientes se seleccionaron sobre la base de criterios de inclusión. El estudio incluyó a 15 pacientes con accidente cerebrovascular izquierdo, pareados por sexo, edad y educación a 30 adultos neurológicamente sanos. Los datos resultantes de la aplicación de la prueba breve de evaluación neuropsicológica NEUPSILIN fueron analizados con el test no paramétrico U de Mann-Whitney. Fue encontrada una reducción significativa en el rendimiento de los pacientes con accidente vascular en HI en comparación con los controles sanos en el lenguaje, la memoria de trabajo y de la praxis ideomotora. Los resultados también se encuentran en otros estudios de pacientes con accidente vascular en HI., A avaliação neuropsicológica busca identificar funções cognitivas deficitárias e preservadas para auxiliar no diagnóstico, no prognóstico e na reabilitação do paciente. No Brasil, o AVC é uma das principais causas de internações e a primeira causa de mortalidade e incapacitação. O AVC em hemisfério esquerdo (HE) está associado a diferentes graus de prejuízo de linguagem e a outros prejuízos cognitivos, por exemplo, na memória. Objetivou-se comparar o desempenho em tarefas neuropsicológicas breves de pacientes pós-AVC de HE, na ausência de quadro afásico moderado ou grave, com controles saudáveis. Uma lista de 135 pacientes foi selecionada com base em critérios de inclusão. Participaram do estudo 15 pacientes com lesão vascular esquerda, emparelhados por sexo, idade e escolaridade a 30 adultos neurologicamente saudáveis. Os dados resultantes da aplicação do Instrumento de Avaliação Neuropsicológica Breve NEUPSILIN foram analisados com o Teste não paramétrico U de Mann-Withney. Os adultos com AVC de HE apresentaram redução significativa no desempenho quando comparados a controles saudáveis em linguagem, memória de trabalho e praxia ideomotora, resultados também encontrados em outros estudos com pacientes com lesão vascular no HE.

Published
2013

32. Avaliação neuropsicológica breve de adultos pós-acidente vascular cerebral em hemisfério esquerdo

Author

Pawlowski, Josiane, Carvalho Rodrigues, Jaqueline de, Ouriques Martins, Sheila Cristina, Brondani, Rosane, Fagundes Chaves, Márcia Lorena, Paz Fonseca, Rochele, Ruschel Bandeira, Denise, Pawlowski, Josiane, Carvalho Rodrigues, Jaqueline de, Ouriques Martins, Sheila Cristina, Brondani, Rosane, Fagundes Chaves, Márcia Lorena, Paz Fonseca, Rochele, and Ruschel Bandeira, Denise

Abstract

The neuropsychological assessment investigates cognitive deficits to improve the diagnosis, the prognosis and the rehabilitation of patients. In Brazil, stroke is a major cause of hospitalization and the leading cause of mortality and disability. The stroke in the left hemisphere (LH) is associated with different degrees of loss of language and other cognitive impairments, for example, in the memory. We compared the performance in brief neuropsychological tasks of the left hemisphere poststroke patients, without moderate or severe aphasia, with healthy controls. A list of 135 patients was selected based on inclusion criteria. The study included 15 patients with left stroke, paired by sex, age and education to 30 neurologically healthy adults. The data resulting from application of the Neupsilin Brief Neuropsychological Assessment Instrument were analyzed with the nonparametric Mann-Whitney U. Adults with LH stroke showed a significant reduction in performance when compared to healthy controls on language, working memory and ideomotor praxis, results also found in other studies of patients with left hemisphere stroke., A avaliação neuropsicológica busca identificar funções cognitivas deficitárias e preservadas para auxiliar no diagnóstico, no prognóstico e na reabilitação do paciente. No Brasil, o AVC é uma das principais causas de internações e a primeira causa de mortalidade e incapacitação. O AVC em hemisfério esquerdo (HE) está associado a diferentes graus de prejuízo de linguagem e a outros prejuízos cognitivos, por exemplo, na memória. Objetivou-se comparar o desempenho em tarefas neuropsicológicas breves de pacientes pós-AVC de HE, na ausência de quadro afásico moderado ou grave, com controles saudáveis. Uma lista de 135 pacientes foi selecionada com base em critérios de inclusão. Participaram do estudo 15 pacientes com lesão vascular esquerda, emparelhados por sexo, idade e escolaridade a 30 adultos neurologicamente saudáveis. Os dados resultantes da aplicação do Instrumento de Avaliação Neuropsicológica Breve Neupsilin foram analisados com o Teste não paramétrico U de Mann-Withney. Os adultos com AVC de HE apresentaram redução significativa no desempenho quando comparados a controles saudáveis em linguagem, memória de trabalho e praxia ideomotora, resultados também encontrados em outros estudos com pacientes com lesão vascular no HE., La evaluación neuropsicológica investiga los déficits cognitivos para mejorar el diagnóstico, el pronóstico y la rehabilitación de los pacientes. En Brasil, el accidente cerebrovascular es una causa importante de hospitalización y la principal causa de mortalidad y discapacidad. El accidente cerebrovascular en el hemisferio izquierdo (HI) se asocia con diferentes grados de pérdida de lenguaje y otros deterioros cognitivos, por ejemplo, en la memoria. Se comparó el rendimiento neuropsicológico en pruebas breves de pacientes sin afasia moderada o grave, después del accidente cerebrovascular en hemisferio izquierdo, con los controles sanos. Una lista de 135 pacientes se seleccionaron sobre la base de criterios de inclusión. El estudio incluyó a 15 pacientes con accidente cerebrovascular izquierdo, pareados por sexo, edad y educación a 30 adultos neurológicamente sanos. Los datos resultantes de la aplicación de la prueba breve de evaluación neuropsicológica Neupsilin fueron analizados con el test no paramétrico U de Mann-Whitney. Fue encontrada una reducción significativa en el rendimiento de los pacientes con accidente vascular en HI en comparación con los controles sanos en el lenguaje, la memoria de trabajo y de la praxis ideomotora. Los resultados también se encuentran en otros estudios de pacientes con accidente vascular en HI.

Published
2013

34. Trombólise no AVCI agudo em um Hospital da Rede Pública

Author

Martins, Sheila Cristina Ouriques, primary, Brondani, Rosane, additional, Frohlich, Alan Christmann, additional, Castilhos, Raphael Machado, additional, Dallalba, Cleber Camilo, additional, Mesquita, Jéssica Brugnera, additional, Chaves, Márcia Lorena Fagundes, additional, and Nasi, Luiz Antonio, additional

Published
1999
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